PacificSource is looking for a way to make an impact and help people by improving member access to quality, affordable care through data analysis and quality program execution.
Requirements
- Proven proficiency in data analysis tools and software (e.g., Excel, SAS, SQL) and data visualization/analytics tools (Tableau, Power BI) required.
- Knowledge of CMS Stars rating and OHA Quality Incentive measures including HEDIS, CAHPS, PQA/Pharmacy, HOS, and Display measures.
- Demonstrated skills in quality improvement concepts, healthcare data analysis, data mining methods and the identification of population health issues, trends, and health disparities using healthcare data sources.
- Demonstrated ability to analyze complex data sets, identify patterns, and drive actionable insights.
- Familiarity with statistical analysis and machine learning techniques is a plus.
- Ability to identify and resolve technical issues in a timely manner.
- Minimum of 3 years of experience in data analysis or a related field required.
Responsibilities
- Collect, analyze, and interpret quality performance and results using statistical techniques.
- Generate regular reports on performance metrics, trends, and areas for improvement.
- Develop and maintain dashboards to track key performance indicators (KPI).
- Execute quantitative analyses that translate data into actionable insights.
- Review reports and performance indicators to improve quality ratings.
- Provide analytical and data-driven, decision-making support for key projects.
- Identify opportunities for improvement in quality ratings and measures.
Other
- Responsible for supporting the execution of the assigned quality program strategy through data analysis to drive results to improve or maintain quality performance, outcomes and/or rating.
- This position will be responsible for the development of reports, enhancements to existing reports, data analysis, and business processes which will inform and enable leader(s) to make informed decisions based on data.
- This position involves collaborating with cross-functional teams, ensuring the accuracy and completeness of Quality data, to optimize processes to enhance performance, maximize revenue and ensure compliance.
- Work closely with internal departments, including clinical, operations, and customer service teams, to align quality improvement efforts.
- Communicate findings and recommendations to senior management and other stakeholders.
